71496A_James T. Campbell_20180516

N_ 71496
gCAMA/ODPEDDE{FILL � B C D
GENERAL PERMIT prevlona permit#
[jNeW Dilo raticn OCanpletelhekaue OPartlaliti Date preNos permit awed
N amhomel6 the Sete m NeM Cmdlm, D,mmmmt N EmimmvenW Curtin
vd the Central Rssourm Cmmmkrpn in m me, emm, m,u]rwvxn Wrswnt to l Sp NCAC /// IJOD I
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Applicant Name „lp5 l rn.. tell Project LoConcertn: CaunLqr¢
Addreas�1.K R MC e P.l. StreetMdret(State nead!Let #(s)
City_ F n�LrA Stared. 1[ZIPalfflap 3d] BA; V acj rd
PM10 e# —
(3i1 a9/ -/aASSE-Mbl IS...e_ava zr Trm onsubdimslon M h.a. Viaey d Sc hon 1
Authorized Agent nor„^. e &dY h.nd Chro n{ en zip �.RYW/
ARectel DEW qW OPTA DES opts phone#( ) I MrerEmin_l-=uv✓',&k
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M PMMNum Perm#oc rPMxdNarm
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FIC Division of Coastal Mot. Habitat Impact Computer Sheet
AppliOam: Same I. Cwrepbtil P.mnx: �1N96 fl
Dale: 64e Is
Morgan bet re the HABITAT dishwashers for the eppllwlim. All values should nri The name, and units M measurement
IOuM In your Hebnet rode sM1M.
Habitat Name
DISTURB TYPE
Cneete One
TOTAL Eq. Ft.
(Applailw.
Enwhrm
ueul
ProuduznY
arsideM
mlwaranor
sau m
FINAL Sq. A.
IMmpleaBw
diaoree.
Qv
EaN.tlpens
rmge0.^n
arms Her
m
TOTAL Feet
pergagaw
Distributor
Mallear
uryenWpam
weather
m or
FINAL F&I
(Mb wb
elwuMrce.
Eratersany
rmwetlm arNa
Imp tyres
as lurk.
Dread FIN D car 0 Over ®
Made ED Arm 0 Oure ❑
o"'I HAD Bd1r 0 Weri
DrealsO FIND Bush 0 Mar
Dradso ME Bush Me
Mi MID Boa 0 oar ❑
usage MY Sam Mar
Dralga0 FIN Barra Mar
Dr Ain Boars Me
aredina0 Flirt Mao Mar
Dressu MID eamn oar❑
Orwye0 FAO Sago oar❑
charter Fig BwAO Mar
Delhi MID mBr 0 oar ❑
under FIN 0 Boa O oaa ❑
I.9931AR000BT rr W .necaeeblmawurnownteel terlxdr o2r03110

N1meuFPmP@rYOvrmwRoqUesfinQPwmCt3an2n cAMQbVt1
...
a• >.<
-B&K IaftC4Aock
at MY PMWrty located at3Z9 M VI lAl - A
in �Y-e County.
I Iurlhennore cevG/y that I ar alAwked to grant and do in fad grant permission to
Dma/on of Coastal Managemerd staff, the Local Permit OBcerand Inalragenb to enter
on Um aforementioned lands in connection with evsarotirg inlwmatiwr related to th/s
pem it application.
Sgn4ate
Ti4mc--f L LC4 MP4EI�
�N or Type Name
e
4 17L moor
Dols
This ced fir bon is valid through

CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONAYAIVER FORM
Now of Property Owner. Jijrn1 /. NIM1210,W �9 ,a ,,
Address of Property: 1•,e�""eV 1IIN2l�Qyd Fd mq&-of6
r� (LO[''W�Sbrr¢,,e1f.51re¢l Or Pat B County)
Agent's Name 8: fl1bffrigYU �41LMailing Address: PQ box 5O
Agent's phone* 2Sa-a(a(--114Leto kl(( buebtl t1Ils. Al t—?1945'
I hereby cerey that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the cached draw y the development
they are proposirg,Adeactoition at slowing, mon dMeareflani, nowsi U gingohledtes; letter.
✓ 1 have no objections to This proposal. __ 1 have objections to this proposal
NwuAawpbjecgons to whatlsbeingpmposWpumusino*MeDl iaofCoa Iffenegemenl
fOC/.g In wMing wale 10 days of retailer of Nla hopes. Comact Information for OCM offices Is
awlla6bat orby calling 48881flCOAST.
No response is considered Me same as no oblect(on H Wu be" been notified by CartMVOMeII.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
beset back a minimum distance of 15' from my area of riparian access uMess waived by me. (If
you wish to waive me setback, you must
initial appropriate blank
,iF.f
1 dowishto waive the setback
em eguheet.
1 do not wish to waive the 15" setback we remen _
(Property Owner information) (Fiber an Prop dy wear Information)
x iW wi
Signature Signature
JIM1 C�AoNitcP FGVLW P.ee,I
Print p/Type Name Pdnl or Type me
' (k aT rk—ywLr Kid Po Box 106%
McArgAWress Meaing Address
'EvArlkfaydUlV a443Sa TLi9,ytateZp�4<oaNC'.2'iFsbl
Clry/SlafeZp dYyS
Tehphom NumM//EmallAlIx dress TelepMne Numbe//Emell Adrhess
(Revised Aup. W14J

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN/.
PROPETY ROWNER NOTIFICATIONIWAIVER FORM
Name of Property Omer; AM l GIN �O.L
Address of Property' 3a�1 P✓io`I'I�OV UINEUQYd �1 Man+.eo
µotw StreNn, streetwhoa ay aDouny)
Agent's Names: P'Iilh AJU 'AV [Kkal d 5liMITNAddress: PO .Bbic SD
Agent'sphone #:2SYale l-'1N1.o kill 1bjjttt k6IIS )VC T1gq
I hereby cer iy that I own property adjacent to the above referenced property. The individual
aDDlyind f this permit has described to me as shown on the attached drawing the development
they are reposing. i ion m b vide t .
I have no objections to this proposal. I have objections to this proposal.
Hyou have objection 0 what Hbeingproposed, younine! nomy Me Decision orCouNlManaganenr
(OChQ In WieOng whole 10 days of reeeept of Nls notice. Contact information for DCM choose Is
available eth J blmena cMstaH l/slin or OycallessfdBaiRCDAST.
No response Is consWered Me "me" no oblecflon Hyou have been notMeel by CeMW Mall,
WAIVER SECTION
I understand that a pier, dock, mooring pllings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must Me appropriate blank below.)
do wish to waive the 15'setback requirement.
I do not Man to waive the 15'setback requirement.
(Property Owner Information)
Signature
I'rMl w ryce Nance
etas M rl(- P 4 QC[
MCIffis AWress
g6fI) tYA.VJV 2Ciia138
ChY6eMBZp
Tekphan Number/EmWArMioss
(Rip n operty Owner lnl_ ormtlionf
Signature
AA'fa ICI C�gIt AON
lhlntwName
Name
333 AAAI.er Vl"AUI-41
MalliigAMreu
MAn+ru, N c z'ts sH
CMrslarorzip
X Q
Telepllme umber EmellA u
IMre
(ReviaedAvg ROfp

Albemarb Bulkbea,ls ana Hooso Rifts
Post Mca Box 59
Kill Devil Hills, NC 279a9
(252)E61-7966 Of/ke
(262)715.19M Fax `t'^
whapettere WS7@allwm
a lbsma/Iobulklka bxftmoll.wm
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